Medicaid vote a tough call for Democrats

Democratic legislators say they are torn about whether or not to vote against HB 5301, budget language pertaining to the state’s Medicaid program.

On one hand, they find a lot of good things in the legislation. At the top of their list is the ability for lower-wage state employees to enroll their children in the KidCare health insurance program, a hard-fought win for Democrats.

But there is another provision in the legislation that they dislike: the state’s attempt to force counties to pay back roughly $300 million in disputed Medicaid bills by withholding revenue sharing over 5 years. The legislation would require counties to either pay back 85 percent of the disputed bills, or they can pay the entire amount up front then prove to an administrative judge that the bills are incorrect and get credited money back.

Senate Minority Leader Nan Rich, D-Weston, has pushed for the KidCare provision and said she was jubilant when she learned it was in this year’s budget. But she is still not sure how she’ll vote on HB 5301.

“The county language is not good,” she said earlier this week. “It’s a huge impact to the counties, and it’s a very short period of time (to pay the money back).”

Both chambers will take up the legislation today, the final day of session. The House has already debated, but not voted on, HB 5301. The Senate hasn't yet taken it up on the floor.

Speaking in favor of the measure, Republicans have defending the new billing system for the counties. The money is owed and needs to be paid back, they say. Besides, the measure has many other provisions that are good for Floridians, Rep. Matt Hudson, R-Naples, said.

“Members, don’t vote against this bill,” Hudson said. “You can’t vote against this bill. You have a duty to vote yes.”

Still, several Democrat representatives spoke against the legislation and indicated they will vote "no."

Rep. Jim Waldman, D-Coconut Creek, lamented the state’s decision to withhold revenue sharing dollars from counties for money counties don’t believe they owe. Counties argue the appeal process is limiting and requires them to pay disputed amounts up front. That is now how it works in the business world, he said.

“You don’t pay anything until the people who say you owe them money prove you owe them money," Waldman said.